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Acceptance and importance of clinical pharmacists' LIMM-based recommendations.

https://arctichealth.org/en/permalink/ahliterature127887
Source
Int J Clin Pharm. 2012 Apr;34(2):272-6
Publication Type
Article
Date
Apr-2012
Author
Asa Bondesson
Lydia Holmdahl
Patrik Midlöv
Peter Höglund
Emmy Andersson
Tommy Eriksson
Author Affiliation
Department of Clinical Pharmacology, Lund University, Lund, Sweden. asa.c.bondesson@skane.se
Source
Int J Clin Pharm. 2012 Apr;34(2):272-6
Date
Apr-2012
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Attitude of Health Personnel
Drug-Related Side Effects and Adverse Reactions
Female
Health Knowledge, Attitudes, Practice
Humans
Interdisciplinary Communication
Male
Medication Errors - prevention & control
Medication Reconciliation - organization & administration
Medication Therapy Management - organization & administration - standards
Middle Aged
Models, organizational
Patient Care Team - organization & administration
Pharmacists - organization & administration - psychology
Pharmacy Service, Hospital - organization & administration - standards
Physicians - psychology
Quality of Health Care - organization & administration - standards
Retrospective Studies
Risk assessment
Sweden
Abstract
The objective of this study was to evaluate the quality of the clinical pharmacy service in a Swedish hospital according to the Lund Integrated Medicine Management (LIMM) model, in terms of the acceptance and clinical significance of the recommendations made by clinical pharmacists.
The clinical significance of the recommendations made by clinical pharmacists was assessed for a random sample of inpatients receiving the clinical pharmacy service in 2007. Two independent physicians retrospectively ranked the recommendations emerging from errors in the patients' current medication list and actual drug-related problems according to Hatoum, with rankings ranging between 1 (adverse significance) and 6 (extremely significant).
The random sample comprised 132 patients (out of 800 receiving the service). The clinical significance of 197 recommendations was assessed. The physicians accepted and implemented 178 (90%) of the clinical pharmacists' recommendations. Most of these recommendations, 170 (83%), were ranked 3 (somewhat significant) or higher.
This study provides further evidence of the quality of the LIMM model and confirms that the inclusion of clinical pharmacists in a multi-professional team can improve drug therapy for inpatients. The very high level of acceptance by the physicians of the pharmacists' recommendations further demonstrates the effectiveness of the process.
PubMed ID
22252773 View in PubMed
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The adherence support gap: the 'ideal' versus 'reality' of antiretroviral adherence support provided by HIV health providers in clinical practice.

https://arctichealth.org/en/permalink/ahliterature150598
Source
Ann Pharmacother. 2009 Jun;43(6):1036-44
Publication Type
Article
Date
Jun-2009
Author
Laura Y Park-Wyllie
Derek Kam
Ahmed M Bayoumi
Author Affiliation
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada. parkwylliel@smh.toronto.on.ca
Source
Ann Pharmacother. 2009 Jun;43(6):1036-44
Date
Jun-2009
Language
English
Publication Type
Article
Keywords
Anti-HIV Agents - administration & dosage
Attitude of Health Personnel
Data Collection
HIV Infections - drug therapy
Humans
Medication Adherence - statistics & numerical data
Nurses - organization & administration - psychology
Ontario - epidemiology
Pharmacists - organization & administration - psychology
Physicians - organization & administration - psychology
Quality of Health Care
Urban Health Services - statistics & numerical data
Abstract
Guidelines suggest that clinicians should provide their patients with antiretroviral adherence support, but there is uncertainty about the types of adherence support clinicians think are important, the methods they use to provide adherence support, and the barriers they face in providing such support in clinical practice.
To study clinician perspectives on the importance of different antiretroviral adherence support activities and compare these with clinicians' self-reported actual adherence support practices.
From March to August 2005, surveys were mailed to physicians, pharmacists, and nurses who provide care to HIV patients in Ontario, Canada. The 84-item survey asked providers to rate how necessary it was to provide 30 types of adherence support activities and how frequently they actually provided each of the types of adherence support. From this, we assessed healthcare provider perceptions of best or ideal practices in supporting medication adherence and actual or usual care in adherence support provision. We also examined whether an adherence support gap existed between the provision of best practice adherence support and actual adherence support in clinical practice.
One hundred sixty-nine of 300 mailed surveys were returned, for a response rate of 56%. Respondents were highly specialized in HIV care and nearly all practiced in urban settings. Respondents indicated that most of the surveyed adherence support activities should be provided to all patients. However, most clinicians did not actually provide these adherence supports to their patients to the extent that they desired. We calculated an adherence support gap that ranged from 31% to 75% across the different types of adherence support activities.
We observed important adherence support gaps between ideal best practices in the provision of adherence support and actual provision of adherence support in clinical practice.
PubMed ID
19491319 View in PubMed
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An intervention to develop repeat prescribing in community pharmacy.

https://arctichealth.org/en/permalink/ahliterature149380
Source
J Clin Pharm Ther. 2009 Jun;34(3):261-5
Publication Type
Article
Date
Jun-2009
Author
L K Saastamoinen
T J Klaukka
J. Ilomäki
H. Enlund
Author Affiliation
The Social Insurance Institution, Helsinki, Finland. leena.k.saastamoinen@kela.fi
Source
J Clin Pharm Ther. 2009 Jun;34(3):261-5
Date
Jun-2009
Language
English
Publication Type
Article
Keywords
Aged
Community Pharmacy Services - organization & administration
Female
Finland
Humans
Male
Middle Aged
Pharmacists - organization & administration
Physician's Practice Patterns - standards
Physicians, Family - standards
Prescription Drugs - adverse effects - therapeutic use
Professional Role
Abstract
Lack of review of patients' medications in repeat prescribing is common. This and other problems in repeat prescribing need to be addressed. Community pharmacists could be more proactive in the review of chronic medications.
The purpose of this study was to test the feasibility and effects of pharmacists' interventions in repeat prescribing.
The normal repeat prescribing process used at Kuopio University Pharmacy and in Kuopio Health Services was developed by an intervention which included a pharmacist's interview and the annual medication data of the patient that were both transferred to the prescribing physician.
Physicians in the intervention group identified and solved patients' drug-related problems better than was the case in the comparison group with normal repeat prescribing. Over half the patients receiving repeat prescriptions had at least one drug-related problem. The physicians used more information sources to support repeat prescribing in the intervention system.
Community pharmacists are able to improve the quality of physician's repeat prescribing by providing vital information.
PubMed ID
19646075 View in PubMed
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Canadian survey of critical care pharmacists' views and involvement in clinical research.

https://arctichealth.org/en/permalink/ahliterature121159
Source
Ann Pharmacother. 2012 Sep;46(9):1167-73
Publication Type
Article
Date
Sep-2012
Author
Marc M Perreault
Zoé Thiboutot
Lisa D Burry
Louise Rose
Salmaan Kanji
Jaclyn M LeBlanc
Roxane R Carr
David R Williamson
Author Affiliation
McGill University Health Center, Montreal, Quebec, Canada.
Source
Ann Pharmacother. 2012 Sep;46(9):1167-73
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Biomedical Research - organization & administration
Canada
Critical Care
Data Collection
Female
Humans
Intensive Care Units - organization & administration
Male
Pharmacists - organization & administration
Pharmacy
Pharmacy Service, Hospital - organization & administration
Abstract
The involvement of Canadian critical care pharmacists in clinical research is not well documented.
To describe the clinical research experience of Canadian critical care pharmacists, describe their views about clinical research, and identify factors that facilitate their involvement in clinical research.
A cross-sectional electronic survey of Canadian critical care pharmacists was developed through an iterative process and conducted from July to October 2010. We invited 325 pharmacists from 129 hospitals across Canada to participate. Surveys with more than 30% of questions unanswered were discarded.
Analyzable response rate was 66.2%. Overall, 33 pharmacists (15.7%) were highly involved in research, 54 (25.7%) were moderately involved, and 123 (58.6%) were minimally involved. Most respondents (97.2%) believed that critical care pharmacist involvement in research was desirable, and many (80.4%) expressed interest to be more involved in research. Nearly all respondents (99.5%) agreed that more support should be provided to pharmacists interested in conducting research. Pharmacists currently involved in research have obtained higher academic degrees (adjusted OR 11.23; p
PubMed ID
22932309 View in PubMed
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Challenges of standardized continuous quality improvement programs in community pharmacies: the case of SafetyNET-Rx.

https://arctichealth.org/en/permalink/ahliterature126130
Source
Res Social Adm Pharm. 2012 Nov-Dec;8(6):499-508
Publication Type
Article
Author
Todd A Boyle
Neil J MacKinnon
Thomas Mahaffey
Kellie Duggan
Natalie Dow
Author Affiliation
Gerald Schwartz School of Business, St. Francis Xavier University, Antigonish, NS, Canada. tboyle@stfx.ca
Source
Res Social Adm Pharm. 2012 Nov-Dec;8(6):499-508
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Community Pharmacy Services - organization & administration - standards
Guideline Adherence
Humans
Interviews as Topic
Learning
Medication Errors - prevention & control
Nova Scotia
Organizational Objectives
Patient Safety - standards
Pharmacists - organization & administration - psychology
Pharmacists' Aides - organization & administration - psychology
Practice Guidelines as Topic
Program Development
Program Evaluation
Qualitative Research
Quality Assurance, Health Care - organization & administration - standards
Quality Improvement - organization & administration - standards
Quality Indicators, Health Care - organization & administration - standards
Time Factors
Abstract
Research on continuous quality improvement (CQI) in community pharmacies lags in comparison to service, manufacturing, and various health care sectors. As a result, very little is known about the challenges community pharmacies face when implementing CQI programs in general, let alone the challenges of implementing a standardized and technologically sophisticated one.
This research identifies the initial challenges of implementing a standardized CQI program in community pharmacies and how such challenges were addressed by pharmacy staff.
Through qualitative interviews, a multisite study of the SafetyNET-Rx CQI program involving community pharmacies in Nova Scotia, Canada, was performed to identify such challenges. Interviews were conducted with the CQI facilitator (ie, staff pharmacist or technician) in 55 community pharmacies that adopted the SafetyNET-Rx program. Of these 55 pharmacies, 25 were part of large national corporate chains, 22 were part of banner chains, and 8 were independent pharmacies. A total of 10 different corporate chains and banners were represented among the 55 pharmacies. Thematic content analysis using well-established coding procedures was used to explore the interview data and elicit the key challenges faced.
Six major challenges were identified, specifically finding time to report, having all pharmacy staff involved in quality-related event (QRE) reporting, reporting apprehensiveness, changing staff relationships, meeting to discuss QREs, and accepting the online technology. Challenges were addressed in a number of ways including developing a manual-online hybrid reporting system, managers paying staff to meet after hours, and pharmacy managers showing visible commitment to QRE reporting and learning.
This research identifies key challenges to implementing CQI programs in community pharmacies and also provides a starting point for future research relating to how the challenges of QRE reporting and learning in community pharmacies change over time.
PubMed ID
22421196 View in PubMed
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Clinical pharmacist service in the acute ward.

https://arctichealth.org/en/permalink/ahliterature107766
Source
Int J Clin Pharm. 2013 Dec;35(6):1137-51
Publication Type
Article
Date
Dec-2013
Author
Trine Rune Høgh Nielsen
Stig Ejdrup Andersen
Mette Rasmussen
Per Hartvig Honoré
Author Affiliation
Region Zealand Hospital Pharmacy, Næstved Hospital, Ringstedgade 65, 4700, Næstved, Denmark, trn@regionsjaelland.dk.
Source
Int J Clin Pharm. 2013 Dec;35(6):1137-51
Date
Dec-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Denmark
Drug-Related Side Effects and Adverse Reactions - prevention & control
Emergency Service, Hospital - organization & administration
Female
Humans
Male
Medication Errors - prevention & control
Middle Aged
Observer Variation
Pharmacists - organization & administration
Pharmacy Service, Hospital - organization & administration
Physicians - statistics & numerical data
Professional Role
Workflow
Abstract
The majority of hospitalised patients have drug-related problems. Clinical pharmacist services including medication history, medication reconciliation and medication review may reduce the number of drug-related problems. Acute and emergency hospital services have changed considerably during the past decade in Denmark, and the new fast-paced workflows pose new challenges for the provision of clinical pharmacist service.
To describe and evaluate a method for a clinical pharmacist service that is relevant and fit the workflow of the medical care in the acute ward.
Acute wards at three Danish hospitals.
The clinical pharmacist intervention comprised medication history, medication reconciliation, medication review, medical record entries and entry of prescription templates into the electronic medication module. Drug-related problems were categorised using The PCNE Classification V6.2. Inter-rater agreement analysis was used to validate the tool. Acceptance rates were measured as the physicians' approval of prescription templates and according to outcome in the PCNE classification.
Acceptance rate of the clinical pharmacists' interventions through the described method and inter-rater agreement using the PCNE classification for drug-related problems.
During 17 months, 188 patients were included in this study (average age 72 years and 55 % women). The clinical pharmacists found drug-related problems in 85 % of the patients. In the 1,724 prescriptions, 538 drug-related problems were identified. The overall acceptance rate by the physicians for the proposed interventions was 76 % (95 % CI 74-78 %). There was a substantial inter-rater agreement when using the PCNE classification system.
The methods for a clinical pharmacist service in the acute ward in this study have been demonstrated to be relevant and timely. The method received a high acceptance rate, regardless of no need for oral communication, and a substantial inter-rater agreement when classifying the drug-related problems.
PubMed ID
23979824 View in PubMed
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Community pharmacists' prescription intervention practices--exploring variations in practice in Norwegian pharmacies.

https://arctichealth.org/en/permalink/ahliterature97882
Source
Res Social Adm Pharm. 2010 Mar;6(1):6-17
Publication Type
Article
Date
Mar-2010
Author
Ingunn Mandt
Anne Marie Horn
Anders Ekedahl
Anne Gerd Granas
Author Affiliation
Institute for Pharmacy Practice Research, Box 5070 Majorstuen, NO-0301 Oslo, Norway. ingunnma@online.no
Source
Res Social Adm Pharm. 2010 Mar;6(1):6-17
Date
Mar-2010
Language
English
Geographic Location
Norway
Publication Type
Article
Keywords
Attitude of Health Personnel
Biomedical Technology - methods
Clinical Competence
Community Pharmacy Services - organization & administration
Facility Design and Construction
Focus Groups
Humans
Interprofessional Relations
Models, organizational
Norway
Pharmacists - organization & administration - psychology
Pilot Projects
Professional Role
Professional-Patient Relations
Rural Health Services
Time Factors
Urban Health Services
Workflow
Abstract
BACKGROUND: Evidence suggests that prescription intervention frequencies have been found to vary as much as 10-fold among Norwegian pharmacies and among pharmacists within the same pharmacy. OBJECTIVE: To explore community pharmacists' perceptions of how their prescription intervention practices were influenced by their working environment, their technological resources, the physical and social structures of the pharmacies, their relations with colleagues, and to the individual pharmacist's professional skills. METHODS: Two focus groups consisting of 14 community pharmacists in total, from urban and rural areas in Norway, discussed their working procedures and professional judgments related to prescription interventions. Organizational theories were used as theoretical and analytical frameworks in the study. A framework based on Leavitt's organizational model was to structure our interview guide. The study units were the statements of the individual pharmacists. Recurrent themes were identified and condensed. RESULTS: Two processes describing variations in the dispensing workflow including prescription interventions were derived--an active dispensing process extracting information about the patient's medication from several sources and a fast dispensing process focusing mainly on the information available on the prescription. Both workflow processes were used in the same pharmacies and by the same pharmacist but on different occasions. A pharmacy layout allowing interactions between pharmacist and patients and a convenient organization of technology, layout, pharmacist-patient and pharmacist-coworker transactions at the workplace was essential for detecting and solving prescription problems. Pharmacists limited their contact with general practitioners when they considered the problem a formality and/or when they knew the answers themselves. The combined use of dispensing software and the Internet was a driving force toward more independent and cognitively advanced prescription interventions. CONCLUSION: Implementation of a general organizational model made it easier to analyze and interpret the pharmacists' intervention practices. Working environment, technology, management and professional skills may all contribute to variations in pharmacists' prescription intervention practices in and between community pharmacies.
Notes
RefSource: Res Social Adm Pharm. 2010 Mar;6(1):3-5
PubMed ID
20188324 View in PubMed
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Competence, competition and collaboration: Perceived challenges among Swedish community pharmacists engaging in pharmaceutical services provision and research.

https://arctichealth.org/en/permalink/ahliterature310694
Source
Int J Pharm Pract. 2019 Aug; 27(4):346-354
Publication Type
Journal Article
Date
Aug-2019
Author
Pia Frisk
Clary Holtendal
Pia Bastholm-Rahmner
Sofia Kälvemark Sporrong
Author Affiliation
Public Healthcare Services Committee, Stockholm County Council, Stockholm, Sweden.
Source
Int J Pharm Pract. 2019 Aug; 27(4):346-354
Date
Aug-2019
Language
English
Publication Type
Journal Article
Keywords
Adult
Attitude of Health Personnel
Community Pharmacy Services - organization & administration
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Job Satisfaction
Male
Middle Aged
Nurses
Pharmaceutical Research
Pharmacists - organization & administration - psychology
Professional Role
Sweden
Abstract
Creating evidence of effectiveness is an important part of service development. In an ongoing research project Swedish community pharmacists participate in services research by recruiting patients initiated on statins to an adherence-promoting cognitive pharmaceutical service, jointly run by nurses and pharmacists.
To explore the pharmacists' experiences of providing part of the service and their views regarding future participation in practice research aiming at developing cognitive pharmaceutical services.
Focus group interviews were conducted with community pharmacists from pharmacies participating in the project. A semi-structured interview guide was developed, based on the aim and earlier research.
The domains identified were the service itself, operative conditions, the pharmacists' role/profession and stakeholders. The research project was thought to promote the local pharmacy to customers, increase job satisfaction and contribute to service development. However, a perceived lack of competence among pharmacists affected both patient communication and project involvement. Additional resources and strengthened collaboration with other local healthcare were requested. Competition among pharmacy chains was identified as a barrier to patient-centred service provision and research.
The current operative conditions in Swedish community pharmacies were perceived by pharmacists as hampering cognitive pharmaceutical services provision and research. Additional resources, improved communication skills and research competence, and increased collaboration with other healthcare and across pharmacy chains are necessary changes. A stronger patient-centred perspective among all stakeholders is required.
PubMed ID
30707481 View in PubMed
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Dangerous abbreviations: "U" can make a difference!

https://arctichealth.org/en/permalink/ahliterature161674
Source
Dynamics. 2005;16(3):11-5
Publication Type
Article
Date
2005
Author
Christine Koczmara
Valentina Jelincic
Carol Dueck
Author Affiliation
ISMP, Canada.
Source
Dynamics. 2005;16(3):11-5
Date
2005
Language
English
Publication Type
Article
Keywords
Abbreviations as Topic
Adverse Drug Reaction Reporting Systems
Bias (epidemiology)
Canada
Critical Care - organization & administration
Drug Prescriptions - nursing - standards
Handwriting
Humans
Mathematics
Medication Errors - methods - nursing - prevention & control - statistics & numerical data
Medication Systems, Hospital - organization & administration
Nurse's Role
Organizational Culture
Pharmacists - organization & administration
Professional Role
Safety Management - organization & administration
Abstract
Dangerous abbreviations are also known as "error-prone abbreviations". They are referred to as "dangerous" or "error-prone" because they can lead to misinterpretation of orders and other communications, resulting in patient harm or death. Selected medication errors arising from the use of dangerous abbreviations are highlighted in this article, along with examples of such abbreviations and strategies to eliminate their use. This column is intended to enhance the awareness of practitioners who treat and care for critical care patients of the problems associated with using ambiguous abbreviations and to provide suggestions for associated safe practices.
PubMed ID
17725263 View in PubMed
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Source
Am J Pharm Educ. 2008 Dec 15;72(6):128
Publication Type
Article
Date
Dec-15-2008
Author
Zubin Austin
Mary H H Ensom
Author Affiliation
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, M5S 3M2. zubin.austin@utoronto.ca
Source
Am J Pharm Educ. 2008 Dec 15;72(6):128
Date
Dec-15-2008
Language
English
Publication Type
Article
Keywords
Canada
Curriculum
Education, Pharmacy - organization & administration - trends
Humans
Pharmaceutical Services - organization & administration - trends
Pharmacists - organization & administration - trends
Professional Role
Schools, Pharmacy - organization & administration - supply & distribution
Students, Pharmacy
Abstract
In Canada, the education of pharmacists is built upon a foundation of strong, research-intensive publicly funded universities and a universal health-care system that balances government and private financing for prescription medications. The evolution of pharmacy education and practice in Canada has laid the foundation for a variety of emerging trends related to expanded roles for pharmacists, increasing interprofessional collaboration for patient-centered care, and emergence of pharmacy technicians as a soon-to-be regulated professional group in parts of the country. Current challenges include the need to better integrate internationally educated pharmacists within the domestic workforce and tools to ensure continuous professional development and maintenance of competency of practitioners. Academic pharmacy is currently debating how best to manage the need to enhance the pharmacy curriculum to meet current and future skills needs, and whether a doctor of pharmacy (PharmD) degree ought to become the standard entry-to-practice qualification for pharmacists in Canada.
Notes
Cites: CMAJ. 2002 Feb 19;166(4):448-5011873922
Cites: Am J Health Syst Pharm. 2004 Jul 15;61(14):142915332684
Cites: J Interprof Care. 2005 May;19 Suppl 1:39-4816096144
PubMed ID
19325948 View in PubMed
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55 records – page 1 of 6.